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Readers Summary:1. Why can’t you lose weight when you change lifestyle2. What is an uncoupling protein (UCP)3. The difference between Anthony Colpo and Robb Wolf and the Oprah!4. Why Oprah is still fat?5. Dr. Kruse’s screening question for assessing leptin status.

Now that we know definitely that leptin controls all energy production by regulating all the hormones in the body, but do you wonder what happens when that regulation goes awry in the muscles? Well, here is a some information about one part of how leptin works to keep us fit when your body is sensitive to it.

When leptin was discovered in 1994 no one really had a clue as to its many functions. One of those functions that was particularly murky was how did the brain control peripheral energy utilization and optimize it. It is awfully hard to realize that the hypothalamus (size of a pea) can control 20 trillion cells in the human body need for fuel. Well, in the last few years scientists found out about uncoupling proteins. (UCP) So far five have been discovered in mammals. The one we will discuss today is UCP3. This protein allows leptin to work inside of peripheral cells like the muscle cell. For UCP3 to work optimally, it requires optimal functioning of leptin and thyroid hormone simultaneously. In muscle cells, UCP3 is the dominant UCP in humans. So it is vital to exercise and energy use to maximize efficiency. What UCP3 allows the muscle to do is shift out of regular oxidative energy production done at the mitochondria and making energy in the form of ATP and into making pure heat without generating ATP. This biochemical action decreases ROS (levee 3) at the mitochondrial level, decreasing cellular stress and the energy is dissipated as mostly heat. UCP1 is dedicated to doing this same action when it is activated 100% of the time.

UCP3 functions in this manner as an alternative pathway to deal with excess energy (calories). This is the reason why you hear people like me and Gary Taubes tell people calories do not matter when you are leptin sensitive. They matter big time to folks who are leptin resistant because they cannot utilize this pathway at all. This is the primary pathway that fat burning occurs peripherally in the human body. If it is not working well or at all the excess calories are sent packing to visceral stores or to organ depots that generate their own set of problems when it occurs chronically.

Let us think about what this means for the muscle cell. If you are Anthony Colpo or Robb Wolf, you can burn whatever fuel you see because your UCP3 is optimal. The fuel source is immaterial, even if the source is high in carbs or high in fats. But lets say you’re Oprah, and you cannot do this, then the muscle cell has to make a choice. Since her UCP3 is not optimal when fuel is delivered to the muscle it cannot be used quickly and builds up. The cell tries to activate UCP3 to dissipate the excess but it requires leptin sensitivity and good T3 and T4 function. We know looking at Oprah she is not optimal. (the mirror test) With exercise Oprah tires quickly and her muscles fatigue faster than Robb’s. WHY? She cannot utilize the fuel. So the excess is sent off to depots, while her muscles are still energy starved, send a signal via the gut to eat more to give the cells fuel. That is precisely what she does over and over again. The problem is the muscles never get the correct amount of fuel in them to meet demands. (Levee 13)

Chronically this excess energy is stored in her fat and no matter how much she works out; she finds it difficult to lose the weight she wants. Sound familiar yet? The cure for her is to stop listening to Dr Oz crazy diet recommendations instead focus in on regaining her leptin sensitivity to make the muscles burn more efficiently.

When her muscles see excess calories consistently, it clogs them with ALE’s from fat and AGE’s from sugars. These are two more levees in THE QUILT. Think about what maple syrup looks like if you left it on your counter top for weeks! It becomes concrete like. That is precisely what happens to a muscles in a type two diabetic chronically because UCP3 is shot. Moreover, the longer it goes on the worse it gets. That condition then begins to effect the nerves that go to the muscles that innervate them and cause pain and sensory dysfunction. This is how fibromyalgia and peripheral neuropathy develops. It begins with a defect in energy metabolism at the muscle level due to peripheral leptin resistance.

So when you think about exercise and performance (Cross fit/Wolf/Colpo) folks one must understand about the CONTEXT your muscles are in when you begin to optimize yourself. This contextual problem is why we have so many competing ideas of how we should advocate exercise for all people. Exercise for Robb or Anthony do not equate with Oprah because their biochemistries are not similar. Here is the best part. Oprah can become equal to them if she has somebody explain this to her. Dr Oz certainly has not for over decade! Her goal is to focus on becoming leptin sensitive by being required by eating 50 grams of protein at breakfast everyday within 30 minutes of rising, eliminating all snacking especially past 730 PM, eating three meals a day, and limiting her carb intake below fifty grams per day for about 6-8 weeks. In my practice, over the last 5 years that is about the bell curve I have seen for most patients to require their regain their signaling back. I check leptin sensitivity by asking a few questions or by ordering a reverse T3 level.

Here are my questions for assessing a patients leptin status…….. Do you notice you sweat more and have less muscle fatigue when you do exercise now? Have your carb cravings gone away? Is your hunger under control now? And are you waking up more refreshed? When these questions are all yes then I push the button and tell them to start exercising more with intensity and duration first using weights and never using aerobics. The reason for weight lifting first is it is generates less ROS in the muscle at the mitochondrial level and more importantly stimulates the release of growth hormone to fire up muscle activity via the neuro endocrine system. It also more quickly reestablishes leptin sensitivity of the furnaces that our muscles contain to burn the fat we want to get rid of. As they improve, more weight comes off and the exercise plan increases. So far this plan has not failed me because it is not based upon my opinion; it is based upon our biochemistry that is 2 million years old! Most of my neurosurgical patients get this treatment before I will operate on them because outcomes are better when the patient is fit metabolically for recovery. If you are a patient who is leptin resistant, and work too hard too quick exercising as you drop weight, the risk is generating too much ROS and depleting their stem cell supply. (Levee 17) The short term effect will be weight loss and a good result but the long term effect may be faster aging and decrease longevity!

This is where the DigitalSurgeon and many trainers don’t see eye to eye. I don’t recommend conventional wisdom…….I rely on the knowns of biochemistry.